Provider Demographics
NPI:1255542916
Name:SCHUGAR, RICHARD ELLIOTT (OD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ELLIOTT
Last Name:SCHUGAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 SAWYER DR
Mailing Address - Street 2:
Mailing Address - City:CUDJOE KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33042-4040
Mailing Address - Country:US
Mailing Address - Phone:305-587-3981
Mailing Address - Fax:303-832-2266
Practice Address - Street 1:182 SAWYER DR
Practice Address - Street 2:
Practice Address - City:CUDJOE KEY
Practice Address - State:FL
Practice Address - Zip Code:33042-4040
Practice Address - Country:US
Practice Address - Phone:305-587-3981
Practice Address - Fax:303-832-2266
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 1184152W00000X
CO2271152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT-30786Medicare UPIN
FL21698Medicare ID - Type Unspecified